The first remedy, phosphorus, began to stop the bleeding that accompanied the diarrhea, Magee says. The second, aloe socotrina, alleviated the diarrhea. More than two years later, Grady is in robust health.

For Epstein, it’s the kind of case that reaffirms her decision to integrate a homeopathic approach into her conventional practice 15 years ago.

“I don’t get excited about a rare diagnosis anymore,” she says. “Rather, I get excited about curing animals, even from common diagnoses like atopy or epilepsy.”

Traditional Start

Epstein, 51, started her career in a conventional way. Two days after graduating from the University of Pennsylvania School of Veterinary Medicine in 1985, she went to work at Wilmington Animal Hospital in Delaware. By 1993 she was an owner of the practice, which received accreditation from the American Animal Hospital Association in 1989. She was nearly 10 years into her career and feeling confident.

“I could make the diagnosis, I could prescribe a drug or a surgery, and if it was something that was beyond my expertise, I could refer [the client] to a specialist,” she says. “And if there was nothing that I could do or that the specialist could do, I just felt comfortable that all that could be done for that animal had been done.”

But then, in 1995, her mother-in-law received a cancer diagnosis and was told she had months to live. Epstein realized that “nothing can be done” wasn’t always a sufficient answer.

She began investigating alternative medicine, which led her to take a course in veterinary homeopathy taught by Richard Pitcairn, DVM, Ph.D. By 1996, she was a certified veterinary homeopath, and her practice took on a holistic approach.

“I have never thrown out all conventional medicine,” Epstein says. For instance, “We just got a digital X-ray unit last fall.”

But clinic protocols changed. Puppies now receive five or fewer vaccinations on average—about half of the agents previously received—and instead of automatically administering annual boosters, titers are used to measure immunity. Epstein also emphasizes wellness, preventive medicine and nutrition, and has hired a veterinary chiropractor. Finally, the emphasis shifted away from pinning a diagnosis on each case.

“With homeopathy, we look at the totality of disease symptoms,” Epstein says. “If an animal comes in and has lameness or diarrhea or changes in disposition, you look at those symptoms for the remedy.”

In homeopathy, “Like cures like,” she says. Based on the initial work of German physician Samuel Hahnemann [1755-1843], homeopathy involves administering diluted succussed preparations of substances that in healthy individuals produce the same symptoms exhibited by the patient.

Business-wise, the practice changed, too. Vaccination revenue dropped to only 1 percent of the clinic’s income, down from 15 percent. Exam fees rose, in large part to account for the longer time spent with each client. Canine annual exams now last 30 minutes, up from 20 minutes previously.

The change in vaccinations, especially, “was a big deal,” she says. “Some people just left. If they just want shots, they’re going to go to another vet. But really, I don’t have to spend a lot of time on vaccine education anymore. People seek us out.”

Case-Based Reasoning

Homeopathy is based largely on case-based reasoning, which critics sometimes use to dismiss the practice. However, Epstein says, case-based reasoning is at the core of much of conventional veterinary medicine.

“In conventional medicine, only 10 to 20 percent of what we do in a practice is based on randomized clinical trials,” she says.

Moreover, she adds, the body of science on homeopathy and other alternative treatments is growing. Epstein will give a presentation on evidence-based homeopathy at the North American Veterinary Conference in January. She’s also working on other case reports and research, including partnering with another researcher to develop a quality-of-life evaluation that could be used in clinical trials of homeopathic remedies.

At the same time, Epstein maintains her clinic’s accreditation with the AAHA. Wilmington Animal Hospital’s six veterinarians follow the same protocols and do the same workups. A full-time associate practices strictly conventional medicine. Epstein may choose to treat an animal conventionally if the case or the client indicates that is the best option, or blend approaches. After years, the choice is usually clear, she says. For instance, one day recently Epstein did four dentals using nearly identical sedative and anesthetic protocols on all four dogs. One of the dogs stayed to board, and the next day he was vomiting and lethargic. The staff used conventional meds to treat the vomiting but were unable to get him to accept oral pain medications.

“When I arrived later in the day I noticed that he seemed ‘drunk,’ ” Epstein reported. “I gave him homeopathic nux vomica and 20 minutes later he was standing at the front of his cage, barking as if to say, ‘What’s a dog gotta do to get a meal around here?’ ”

No matter the modality, she says, the goal remains the same: “What can I do to make these animals better? What’s in the best interest of the animal? When you look at cases from an inclusive perspective, you realize that there are a lot of options available for helping animals.”

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